That’s why I love systematic reviews like these – so I can be substantially more precise in such discussions. Moreso, if you love forest plots – you’ll really love this article.
The high points:
- Agitation associated with procedural sedation is almost entirely the domain of ketamine, at 16% pooled incidence. “Ketofol” brings it down to 4.8%, and the remainder are ~1 in 1000.
- Aspiration was observed once in a pooled multi-agent sample of 2,370 patients.
- Bradycardia was witnessed essentially only in one study using etomidate – otherwise ~1 in 250.
- Hypotension is most frequent with propofol, but still only 2%. The rest fall around 1% or less.
- Hypoxia was a little harder to pin down, with most agents’ results skewed by outlier studies. 5% is probably reasonable for propofol, while ketamine-containing protocols are probably ~1% or lower.
- Laryngospasm was witnessed ~1 in 1,500.
“Incidence of Adverse Events in Adults Undergoing Procedural Sedation in the Emergency Department: A Systematic Review and Meta-analysis”